NPI | 1659943975 |
---|---|
Entity Type | Organization |
Authorized Contact | CHAD PEW Vice President Of Operations 512-730-3060 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-07-15 |
Last Update Date | 2025-04-29 |